Urinary Catheterization Notes
Learning Objectives
Understand the principles of urinary catheterization.
Discuss and perform the urinary catheterization procedure for clients with a vagina and clients with a penis.
Determine indications for catheterization.
Identify potential complications associated with urinary catheterization.
Urinary Elimination Review
Normal urination patterns: Frequency, volume, and characteristics.
Factors affecting voiding:
Food and fluid intake.
Medications.
Muscle tone and activity.
Terminology:
Polyuria: Excessive urination.
Oliguria: Insufficient urination.
Anuria: Absence of urination.
Urinary incontinence: Involuntary leakage of urine.
Urinary retention: Inability to empty the bladder.
Alterations in Urinary Elimination
Urinary Tract Infections (UTIs):
Often a complication from catheterization.
Can have other causal factors as well.
Urinary Incontinence:
Involuntary leakage of urine.
Nocturia:
Waking at night to void.
Associated with aging, overactive bladder, circulatory problems, or prostate enlargement.
Urinary Retention:
Accumulation of urine due to the bladder's inability to empty.
Urinary Diversions:
Diversion of urine to an external source.
Catheterization Overview
A procedure to drain urine from the urinary bladder or instill solutions.
Catheter tubing is inserted through the urethra into the bladder to allow urine drainage.
May also be used for treatment or diagnostic purposes.
Risk: Potential introduction of microorganisms; hence, strict sterile technique is essential.
Types of Catheters & Purposes
Straight Intermittent Catheter: Single lumen designed to drain urine temporarily.
Indwelling Catheter: Remains in place with an inflated balloon;
May have one or more lumens for various functions (drainage, balloon inflation).
Condom Catheter: External catheter for male patients.
Indications for Catheterization
Short Term (<30 days)
Obstructed urine outflow (e.g., prostate enlargement).
Post-surgical repair of bladder/urethra.
To prevent urethral blockage from blood clots.
Measure urinary output in critically ill patients.
Continuous/intermittent bladder irrigations.
Long Term
Unmanageable chronic urinary retention.
Skin irritation from urine contact.
Patients with terminal illness needing comfort measures.
Intermittent Indications
Relieving discomfort from bladder distension.
Obtaining sterile urine specimens.
Assessing residual urine post-voiding.
Managing urethral strictures.
Nursing Interventions
Keep the catheter system closed; avoid bag/tubing contact with the floor.
Ensure drainage bag is below bladder level.
Ensure tubing is kink-free.
Attach drainage bag to bed frame, not to side rails.
Encourage adequate fluid intake (e.g., 3000 ml/day).
Provide perineal care and monitor clients for complications of catheter use.
Complications of Catheterization
Accidental catheter removal.
Bladder discomfort during balloon inflation.
Inability to advance catheter or find urinary meatus.
Infection risk; urinary retention post removal.
Catheter Care Procedures
Routine hygiene necessitates wearing gloves and cleaning from the meatus down.
Empty urinary drainage bags at the end of each shift or when full; measure and record urine output.
Removing Indwelling Catheters
Assess for urinary retention post-removal; gentle bladder retraining may be needed if catheter was in place long-term.
Self-Catheterization Principles
Use clean technique at home; sterile equipment in healthcare settings.
Complications Associated with Catheterization
Urinary tract infection.
Encrustation and blockage.
Tissue damage and patient discomfort.
Conclusion
Catheterization is commonly performed in clinical practice and requires an understanding of urinary anatomy and physiology.
Health education is crucial for patients performing self-catheterization, emphasizing the nurse’s role in providing this knowledge.